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Access over workers' compensation decisions, including En Banc, Significant Panel Decisions, and writ-denied cases.

Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. ADJ1560752
Regular
Sep 09, 2025

EUGENE FLOWERS vs. RAY MAC PAINTING, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) affirmed the January 12, 2021 Findings and Award (F&A) in the case of Eugene Flowers, who sustained an industrial injury to his right shoulder and subsequently alleged a psyche injury. Defendant State Compensation Insurance Fund sought reconsideration, contesting the reasonableness of treatment provided by lien claimant Behavioral Medicine and Health Psychology, liability for statutory increase and interest, and the validity of the lien due to declaration requirements. The WCAB, adopting the WCJ's report, concluded that the applicant's psyche injury was a compensable consequence, the psychological treatment was medically necessary and reasonable, and the lien was not barred by the late filing of the declaration under Labor Code section 4903.8(d). Consequently, the F&A, which ordered payment for adjusted charges along with statutory interest and increase, was upheld.

ReconsiderationFindings and AwardBehavioral Medicine and Health Psychologyindustrial injurypsychemedically reasonablenecessarystatutory increaseinterestlien claimant
References
Case No. ADJ3616652 (SAC 0296975)
Regular
Feb 07, 2013

SAMUEL WILLIAMS vs. STARVING STUDENTS, LEGION INSURANCE COMPANY, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION

This case concerns the applicant's claim for interest on a workers' compensation settlement paid late by Legion Insurance, now administered by CIGA. The applicant was awarded 10% interest on delayed payments, but CIGA sought reconsideration, arguing the interest issue was not properly raised, interest accrued before CIGA's involvement is not covered, and stipulations waived interest. The Appeals Board granted reconsideration, amending the award to apply interest only on payments made on or after March 4, 2003, when CIGA assumed liability, allowing credit for overpayments made to the applicant.

Workers Compensation Appeals BoardLegion InsuranceCIGACompromise and Release AgreementInterest on AwardLiquidationGuarantorStipulationOrder Approving Compromise and ReleaseStatutory Interest
References
Case No. VNO 497379
Regular
Dec 27, 2007

AGNES MERCADO vs. AMERICAN DAWN, INC., HIGHLANDS INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration to correct errors in the original award to lien claimant S&B Surgery Center. The Board reduced the award for certain epidural injections and a lysis procedure based on corrected billing and relevance of the comparative study. Despite defendant's arguments, the Board affirmed the award of statutory interest on unpaid medical bills, finding the defendant failed to meet statutory requirements for contesting payment.

Workers' Compensation Appeals BoardLien ClaimantReconsiderationFindings and AwardEpidural BlocksLumbar DiscographyCompromise and ReleaseLabor Code Section 4603.2Medical TreatmentInterest
References
Case No. ADJ8132431
Regular
Feb 12, 2018

Nichole Delgado vs. EL TEPEYAC CAFÉ; CRMBC(SIG), AMERICAN CLAIMS MANAGEMENT

The Workers' Compensation Appeals Board affirmed a prior decision finding the defendant liable for a lien claimant's photocopying services. The Board determined the lien claimant complied with statutory requirements for valid liens, including a declaration under penalty of perjury. Furthermore, the defendant failed to timely object to the billed services or their reasonableness within the 60-day period mandated by Labor Code section 4622. Consequently, the defendant is liable for the billed amount, a 10% statutory increase, and interest.

Labor Code section 4622Labor Code section 4903.8medical-legal lienphotocopy servicesdeclaration under penalty of perjuryreasonableness of chargesstatutory increaseinterestobjection periodtimely filing
References
Case No. ADJ7469776
Regular
Jun 01, 2015

PAUL PALMER vs. KANSAS CITY CHIEFS, TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

This case concerns whether California workers' compensation jurisdiction applies to an out-of-state professional football player's cumulative injury claim. The Workers' Compensation Appeals Board (WCAB) denied the applicant's petition for reconsideration, affirming the WCJ's finding that the applicant's minimal contact with California (5 out of 62 games) did not establish a sufficient connection for due process under *Federal Insurance Co. v. Workers' Comp. Appeals Bd. (Johnson)*. The majority found that California lacked a legitimate and substantial interest in adjudicating the claim, deeming the applicant's contact "de minimis." Commissioner Sweeney dissented, arguing that California has a substantial interest in injured workers and that the applicant's contact was more than de minimis, thus supporting WCAB jurisdiction.

WCABPaul PalmerKansas City ChiefsTravelers Property Casualty Company of AmericaADJ7469776Petition for ReconsiderationFindings of FactAdministrative Law JudgeWCJFederal Insurance Co. v. Workers' Comp. Appeals Bd. (Johnson)
References
Case No. ADJ4137919 (LAO 0855341) ADJ3018408 (LAO 0855344)
Regular
Dec 15, 2009

Enrique Madrigal vs. KAVLICO CORP, NOVA PRO RISK SOLUTIONS

Lien claimants' Petition for Reconsideration is granted; the Orders of Reimbursement are affirmed, but amended to delete the award of interest.

Petition for ReconsiderationOrder of ReimbursementLien ClaimantsPetition for ReimbursementAmounts Paid in ErrorInterest AwardWCJ's OrderStatutory BasisAppeals BoardDecision After Reconsideration
References
Case No. ADJ3890427 SAC 0364747 ADJ6797951
Regular
Jun 07, 2012

JOHN ERICK RITCHIE vs. CMC/FONTANA STEEL, ACE USA

The applicant sought reconsideration of an award for industrial injuries, primarily arguing the $15\%$ penalty for delayed payments was too low. The Workers' Compensation Appeals Board (WCAB) granted reconsideration, rescinded the original decision, and returned the matter for further proceedings. The WCAB clarified that statutory interest for delayed payments is $10\%$ and any accrued interest on attorney fees must be paid to the attorney. The WCAB also noted ambiguity regarding penalties for delayed attorney fees, stating such penalties are payable to the applicant.

WCABindustrial injurylow backpsycheiron workerpermanent disability indemnityattorney feesLabor Code section 5814penalty increasestatutory interest
References
Case No. ADJ9531226
Regular
Dec 04, 2018

JULICES MARTINEZ vs. SUN VALLEY GROUP, ZENITH INSURANCE COMPANY

The Workers' Compensation Appeals Board denied a lien claimant's petition for reconsideration, upholding the administrative law judge's decision. The lien claimant argued that the defendant's explanations of review (EORs) were deficient and did not trigger the lien claimant's obligation to request a second review. However, the Board found that the defendant's EORs substantially complied with statutory requirements and provided sufficient guidance to the lien claimant. Because the lien claimant failed to request a second review within the statutory timeframe, their objections to the billing were deemed waived.

Workers' Compensation Appeals BoardLien ClaimantExplanation of Review (EOR)Labor Code Section 4622Medical-legal ExpensesContested ClaimPetition for ReconsiderationAdministrative Director Rule 9794Second ReviewBill Review
References
Case No. ADJ1367543 (POM 0286181)
Regular
May 11, 2012

XJU BIN CAO vs. WO HIN INTERNATIONAL, INC., BERKSHIRE HATHAWAY

The Appeals Board rescinded the WCJ's decision, finding that the November 3, 2010 Stipulation and Order was an enforceable contract despite the parties' differing interpretations of unstated interest and penalty clauses. The Board ruled the lien claimant is entitled to interest under Labor Code section 5800 on the $17,000 payment from the agreement date to payment. However, no penalty was awarded as the defendant's delay in payment was not deemed unreasonable.

Workers' Compensation Appeals BoardReconsiderationStipulation and OrderMeeting of the MindsLabor Code Section 5800Lien ClaimantInterestPenaltiesLabor Code Section 5814Unreasonable Delay
References
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